The arrival of high speed digital electronic and communication technologies in radiological sciences is gradually changing the method of acquiring, communicating, storing, retrieving, viewing, and manipulating diagnostic images. One natural development from this change is the emergence of the digital radiology department. Five major issues in a digital-based operation radiology department are technological feasibility, diagnostic image quality, clinical implementation, clinical assessment, and system utilization and research applications. During the past six years with the support from the existing grant, we have solved the first two issues related to pediatric radiology. We are now ready to move on to the other PACS issues of clinical implementation, assessment and research applications. The specific aim of this research proposal is to continue developing the digital-based operation in pediatric radiology. Two hypotheses are investigated: (1) The digital-based operation to be implemented can effectively replace the current film-based operation for all tasks necessary for routine clinical operation. The framework developed in this study will allow new clinical machines and information management systems to be easily incorporated into the larger departmental schema. (2) The digital-based operation provides the framework to effectively perform education and research activities. The digital-based operation developed in this study will allow new image and database analysis modules to be easily connected to a large repository of information stored in the departmental picture archiving and communication system (PACS). The first hypothesis will be tested by first completing the implementation of a digital-based operation in pediatric radiology, then performing statistical tests to assess whether performance differences exist between the two alternative systems (film -vs- digital). The second hypothesis tests the ability for the digital-based operation to facilitate education and research. Two tasks, one on developing a pediatric MR interactive teaching module and the other on a pediatric skeletal model, will be performed to test the hypothesis. If we are successful, the practice, teaching, and research of Pediatric Radiology will change potentially not only in the United States but internationally. Development of a digital-based Pediatric Radiology Section will allow much more effective patient care and radiology consultation as well as better methods of teaching and research in Pediatric Radiology. Development of a scientific database will allow a better understanding of the normal and the pathological status of childrens' disease processes.